Interaction of pain and chronic inflammation

Seifert, Olga; Baerwald, Christoph

doi:10.1007/s00393-020-00951-8

Cited by 31 publications

(26 citation statements)

References 27 publications

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“…Often, heat-responsive unmyelinated afferents develop mechanical sensitivity only in the injury setting [ 11 ]. These afferents are more responsive to chemical stimuli (capsaicin or histamine) and are likely to come into play when the chemical milieu of inflammation changes their properties [ 1 , 2 , 12 , 13 , 14 ]. However, not all C fibers are nociceptors.…”

Section: Introductionmentioning

confidence: 99%

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Sinhorim

Amorim

Ortiz

et al. 2021

JCM

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Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over the past few decades; however, these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting lower back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane, and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies satisfied the following: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, after which data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met the inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in lower back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Additional knowledge of fascial neurological components could impact LBP treatment.

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Section: Introductionmentioning

confidence: 99%

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Sinhorim

Amorim

Ortiz

et al. 2021

JCM

View full text Add to dashboard Cite

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“…Often, heat-responsive unmyelinated afferents develop mechanical sensitivity only in the injury setting [11]. These afferents are more responsive to chemical stimuli (capsaicin or histamine) and are likely to come into play when the chemical milieu of inflammation changes their properties [1,2,[12][13][14]. However, not all C fibers are nociceptors.…”

Section: Introductionmentioning

confidence: 99%

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving in Vivo and Ex Vivo Studies

Sinhorim

Amorim

Ortiz

et al. 2021

Preprint

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Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over decades, however these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting low back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies were: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in low back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Greater knowledge of fascial neurological components could impact LBP treatment.

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“…Как было представлено выше, через ВСП JAK/STAT происходит активация клеток, участвующих в развитии аутоиммунного воспаления, а также экспрессия генов, ответственных за синтез биологически активных субстанций, участвующих в формировании периферической гипералгезии и ЦС -циклооксигеназы 2, матриксной простагландин Е2-синтетазы, матриксных металлопротеиназ (ММП), субстанции Р, фактора роста нервов, и др. Блокада данного ВСП препятствует развитию цитокин-опосредованных нейропластических изменений ноцицептивных нейронов -в частности связанных с гиперпродукцией интерлейкина 6 и затрагивающих как задние рога спинного мозга, так и вышележащие отделы нервной системы [6][7][8].…”

Section: Discussionunclassified

“…Высокая важнейшего элемента патогенеза хронической боли, феномена центральной сенситизации (ЦС) -функциональных изменений ноцицептивной системы, существенно повышающих возбудимость нейронов и снижающих болевой порог [6][7][8]. Ранее нами была представлена работа, в которой исследовалось влияние ТОФА на боль и ЦС при РА [9].…”

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Evaluation of the effectiveness of Tofacitinib in rheumatoid arthritis in real clinical practice: The relationship between pain relief in the first 4 weeks and disease activity after 3–6 months

Каратеев¹,

Погожева²,

Амирджанова³

et al. 2021

Naučno-praktičeskaâ revmatologiâ

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The JAK inhibitor tofacitinib (TOFA) blocks the intracellular signaling pathway that activates the synthesis of cytokines and mediators involved in the development of pain and central sensitization (CS), which determines the rapid analgesic effect. However, it is not clear how pain reduction is associated with achieving low activity in rheumatoid arthritis (RA).The aim of the study was to assess the relationship between the early clinical response to tofacitinib and a decrease in rheumatoid arthritis activity after 3 and 6 months.Material and methods. The study group consisted of 88 RA patients (age – 53±11.5 years; 79.3% of women) who received basic anti-inflammatory drugs (59.5% – methotrexate, 19.8% – leflunomide) and who were prescribed TOFA in a dose 10 mg/day. Seropositivity for rheumatoid factor was 89.8%; the value of the DAS28 index is 5.2±1.2. The severity of pain was assessed using the Brief Pain Inventory questionnaire, the neuropathic component of pain (NCP) – using the PainDETECT questionnaire, signs of CS – using the Central Sensitization Inventory (CSI) questionnaire in the early stages after the administration of TOFA, RA activity – using the DAS28-CRP index after 3 and 6 months.Results. The mean severity of pain at baseline was 5.3±2.0 on the visual analogue scale (VAS); 51.1% of patients had signs of CS (CSI>40), 15.9% had NCP (PainDETECT>18). 7 days after the start of therapy, there was a significant decrease in pain – to 4.1±1.8 according to VAS (p<0.05) and CS – 40.4±13.5 to 36.5±12.5 according to CSI (p=0.01). After 28 days, the effect was even more significant: the level of pain according to the VAS was 2.8±1.6 (p=0.000), the NCP decreased from 11.8±5.6 to 6.8±3.1 (p=0.000), CS – up to 31.6±13.9 (p=0.000). The value of the DAS28-CRP index after 3 and 6 months was 3.7±1.3 and 3.6±1.2, respectively. The number of patients with pain relief ≥50% after 28 days was 59.9%, low RA activity after 3 months. (DAS28-CRP≤3.2) was acieved in 64.4% of patients. There was a clear correlation between the number of patients with a pain reduction of ≥50% at 28 days and the number of patients who achieved low RA activity at 3 and 6 months. (rS=0.548, p=0.000 and rS=0.790, p=0.000). 6 patients dropped out of the study due to inefficiency or social reasons. No serious adverse reactions were noted.Conclusions. The use of the JAK inhibitor TOFA allows achieving a quick analgesic effect and reducing the signs of CS. An early clinical response to TOFA (pain relief) predicts a decrease in RA activity after 3 and 6 months of therapy.

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Interaction of pain and chronic inflammation

Cited by 31 publications

References 27 publications

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving in Vivo and Ex Vivo Studies

Evaluation of the effectiveness of Tofacitinib in rheumatoid arthritis in real clinical practice: The relationship between pain relief in the first 4 weeks and disease activity after 3–6 months

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